| NPI | 1023149127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX E4646) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: TX E4646) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2009-10-27 |